National Provider Identifier
Crestwood Children'S Center
Crestwood Children'S Center is listed in the NPPES registry with a primary specialty of Emotionally Disturbed Childrens' Residential Treatment Facility in Rochester, NY and a listed phone number of (585) 654-1418.
Profile Overview
- NPI
- 1346576568
- Provider Type
- Organization
- Primary Specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Enumeration Date
- October 22, 2009
- Last Updated
- October 22, 2009
Practice Location
- 1183 Monroe Ave
- Rochester, NY 14620-1662
Phone: (585) 654-1418
Specialties
- Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X)
Full Record
- NPI
- 1346576568
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Crestwood Children'S Center
- Mailing Street Address
- 1183 Monroe Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-1662
- Mailing Country
- US
- Mailing Phone
- (585) 654-1418
- Mailing Fax
- (585) 654-1450
- Practice Street Address
- 1183 Monroe Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-1662
- Practice Country
- US
- Practice Phone
- (585) 654-1418
- Practice Fax
- (585) 654-1450
- Enumeration Date
- October 22, 2009
- Last Updated
- October 22, 2009
- Authorized Official Last Name
- Antinone
- Authorized Official First Name
- Gary
- Authorized Official Title
- Accounts Receivable
- Authorized Official Phone
- (585) 654-1418
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mr.
- Taxonomies
- Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X)
- Other Identifiers
- 00788041 (NY)